(DISPONIBLE EN FRANÇAIS - IMM 1324 F)

PROTECTED WHEN COMPLETED - B

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UNDERTAKING / APPLICATION FOR A JOINT ASSISTANCE SPONSORSHIP SPONSORSHIP AGREEMENT HOLDERS AND CONSTITUENT GROUPS

IMM 1324 (06-2020) E

FOR IRCC USE ONLYIRCC file identification no.

BPrincipal Applicant ID no.

Name of Principal Refugee Applicant (PA)

A SPONSORSHIP AGREEMENT HOLDER (completion of this section is mandatory)Name of Sponsorship Agreement Holder (SAH)

FOR IRCC USE ONLY

SAH representative - Surname (Family name) Given name(s) Date of birth (YYYY-MM-DD) SAH identification no.

Other name(s) used (include birth name, maiden, previous married name(s), aliases and nicknames)

Address (no. and street) Apt. - Unit

City Province Postal code

Home telephone no. Business or cell telephone no. Fax no. E-mail address (specify, if available)

B CONSTITUENT GROUP (if applicable)Name of Constituent Group (CG)

FOR IRCC USE ONLY

CG representative - Surname (Family name) Given name(s) Date of birth (YYYY-MM-DD) CG identification no.

Other name(s) used (include birth name, maiden, previous married name(s), aliases and nicknames)

Address (no. and street) Apt. - Unit

City Province Postal code

Home telephone no. Business or cell telephone no. Fax no. E-mail address (specify, if available)

C REFUGEE APPLICANTSNote: include both Accompanying and Non-Accompanying family members or dependants.1 Principal Refugee Applicant - Surname (Family name) Given name(s) FOR IRCC USE ONLY

GenderF Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status

2 Refugee Applicant - Surname (Family name) Given name(s) FOR IRCC USE ONLY

GenderF Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanyingnon-accompanying

3 Refugee Applicant - Surname (Family name) Given name(s) FOR IRCC USE ONLY

GenderF Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanyingnon-accompanying

4 Refugee Applicant - Surname (Family name) Given name(s) FOR IRCC USE ONLY

GenderF Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanyingnon-accompanying

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IMM 1324 (06-2020) E

C REFUGEE APPLICANTS (continued)5 Refugee Applicant - Surname (Family name) Given name(s)

FOR IRCC USE ONLY

Gender

F Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanying

non-accompanying

6 Refugee Applicant - Surname (Family name) Given name(s)FOR IRCC USE ONLY

Gender

F Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanying

non-accompanying

7 Refugee Applicant - Surname (Family name) Given name(s)FOR IRCC USE ONLY

Gender

F Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanying

non-accompanying

8 Refugee Applicant - Surname (Family name) Given name(s)FOR IRCC USE ONLY

Gender

F Female M Male X Another gender

Date of birth (YYYY-MM-DD) Place of birth Country or territory of birth Client identification no.

Country or territory of citizenship Marital status Relationship accompanying

non-accompanying

D IDENTIFICATION OF SPECIAL NEEDSIdentify how the sponsoring group and services available in the community can assist with special needs listed on the refugee profile.

The JAS (Joint Assistance Sponsorship) cases are a shared responsibility. They work best when partners understand the role of one another. Listed below are obligations of the sponsor, Immigration Refugees and Citizenship Canada (IRCC) and the role of the RAP (Resettlement Assistance Program) service providing organization.E OBLIGATIONS

The sponsor agrees to provide the following assistance to the refugee(s) named on this application until they become continuously self-supporting. The obligations under this agreement are for a period up to 24 months from the date the refugee(s) arrive in Canada.1. Teach rights and responsibilities of permanent residence in Canada; 2. Show where and how to arrange for services and accompanying them to different services; 3. Ensure that special needs are met through appropriate referral and support services; 4. Provide general companionship and settlement counselling as required; 5. Provide assistance in finding employment; 6. Help the refugee(s) learn one of Canada's official languages; 7. Act as an advocate to help the refugee(s) obtain the assistance required for integration into Canadian society.

Do you agree to provide this support? Yes No

IRCC (Immigration Refugees and Citizenship Canada) agrees to provide the following assistance to refugee(s) named on this application for a period up to 24 months from the date the refugee(s) arrive in Canada or until they become continuously self-supporting, whichever comes first.1. Financial assistance equivalent to provincial social assistance rates to meet basic food, shelter and clothing needs; 2. Start-up costs including: one time payments for clothing, household effects, linens, staple food, furniture; 3. Access to emergency medical services - Interim Federal Health; 4. Access to assistance loans for the deposits for rent, utilities and telephone; 5. Access to transportation loans; 6. Access to service provider organizations for assistance with language training and other settlement assistance.

RAP (Resettlement Assistance Program) service providers are funded through IRCC to provide the following services:1. Temporary accommodation for the refugee(s); 2. Up to 18 hours of service may be provided. All services should be provided in consultation with the sponsoring group; 3. Within the 18 hours of service such tasks are provided: airport reception, finding permanent accommodation, financial and basic orientation, assistance in applying for health card(s) and social insurance number(s), links to mandatory broader based programs and services and special needs counselling.

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IMM 1324 (06-2020) E

F DECLARATION BY THE SPONSOR

1. My group is not in default in respect of any other sponsorship undertaking(s). 2. My group understands it's obligations under the Joint Assistance Sponsorship Program, and will make arrangements in the expected community of settlement for the reception and settlement of the persons identified in this undertaking. 3. To the best of my ability, I will not knowingly or deliberately allow any individual to participate in the group's settlement activities who may be considered a threat to the safety and security of the refugee(s).

Name of sponsoring group representative Signature of group representative Date (YYYY-MM-DD)

FOR IRCC USE ONLY

G RELATIVES OF REFUGEE(S) LIVING IN CANADAFrom information provided by the visa office, identify if the refugee(s) have relatives in Canada who may be willing to assist the sponsoring group in resettling the refugee(s).

The refugee(s) has relatives living in Canada but they are not willing to assist in the resettlement of the refugee(s).

The refugee(s) did not identify that they have any relatives in Canada.

The refugee(s) identified that relatives accompanying them to Canada may be able to assist them in the resettlement.

The refugee(s) identified that they have relatives in Canada who are able to assist in their resettlement. - Provide address information below, when available.

Name of refugee's relative(s) living in Canada - if more than one include a separate page with contact information listedSurname (Family name) Given name(s)

Canadian citizen Permanent resident OtherRelationship to refugee(s)

Address (no. & street) Apt. - Unit

City Province Postal code

Home telephone no. Business or cell telephone no. Fax no. E-mail address (specify, if available)

H SPECIAL NEEDS

Indicate if this sponsorship falls within one of the following categories:

Medical disabilities Separated children

Women at risk (AWR) Urgent protection

Elderly refugees Other (specify)

Large family - Socio-economic difficulties

Signature of officer Date (YYYY-MM-DD) IRCC office

IRCC Contact name IRCC Contact no. Visa office Approximate date for completion of processing (YYYY-MM-DD)

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IMM 1324 (06-2020) E

Personal information provided on this form is collected by Immigration, Refugees, and Citizenship Canada (IRCC) under the authority of the Immigration and Refugee Protection Act (IRPA). The personal information will be used for the purpose of processing an application. The personal information provided may be disclosed to other federal government institutions and regulatory bodies for the purpose of validating information and eligibility. The personal information may also be disclosed to law enforcement bodies for the purpose of validating identity, eligibility and admissibility. The personal information may also be disclosed to provincial/territorial governments and foreign governments for the purpose of validating eligibility and admissibility. Personal information may also be used for other purposes including research, statistics, program and policy evaluation, internal audit, compliance, program integrity, risk management, subsequent program eligibility, quality assurance, strategy development and reporting. Failure to complete the form in full may result in a delay or the application not being processed. The Privacy Act gives individuals the right of access to, protection, and correction of their personal information. If you are not satisfied with the manner in which IRCC handles your personal information, you may exercise your right to file a complaint to the Office of Privacy Commissioner of Canada. The collection, use, disclosure and retention of your personal information is further described in IRCC's Personal Information Bank - IRCC PPU 008.